Color Doppler US of normal cerebral venous sinuses in neonates: a comparison with MR venography
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Color Doppler US (CDUS) has been used for evaluation of cerebral venous sinuses in neonates. However, there is very limited information available regarding the appearance of superficial and deep normal cerebral venous sinuses using CDUS and the specificity of the technique to rule out disease.
To determine the specificity, inter-modality and inter-reader agreement of color Doppler US (CDUS). To evaluate normal cerebral venous sinuses in neonates in comparison to MR venography (MRV).
Materials and methods
Newborns undergoing a clinically indicated brain MRI were prospectively evaluated. All underwent a dedicated CDUS of the cerebral venous sinuses within 10 h (mean, 3.5 h, range, and 2–7.6 h) of the MRI study using a standard protocol.
Fifty consecutive neonates participated in the study (30 males [60%]; 25–41 weeks old; mean, 37 weeks). The mean time interval between the date of birth and the CDUS study was 19.1 days. No cases showed evidence of thrombosis. Overall agreement for US reading was 97% (range, 82–100%), for MRV reading, 99% (range, 96–100%) and for intermodality, 100% (range, 96–100%). Excellent US-MRI agreement was noted for superior sagittal sinus, cerebral veins, straight sinus, torcular Herophili, sigmoid sinus, superior jugular veins (94–98%) and transverse sinuses (82–86%). In 10 cases (20%), MRV showed flow gaps whereas normal flow was demonstrated with US. Visualization of the inferior sagittal sinus was limited with both imaging techniques.
Excellent reading agreement was noted for US, MRV and intermodality. CDUS is highly specific to rule out cerebral venous thrombosis in neonates and holds potential for clinical application as part of clinical-laboratory-imaging algorithms of pre/post-test probabilities of disease.
KeywordsColor Doppler US Cerebral venous sinuses MRI MR venography Neonates
We thank the Physicians Services Incorporated Foundation (PSI) and the Sick Kids Trainee’s Start Up Fund, Toronto, Canada, for financial support. Dr. Andrea S. Doria is supported by the Salary Award from the Canadian Child Health Clinicians Scientist Program. We thank Wendy Doda for administrative support. We are grateful to the families who consented to take part in the study, and to the nursing and medical staff members of the Hospital of Sick Children, Toronto, who participated in caring for the infants.
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